{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,11]],"date-time":"2026-11-11T01:29:32Z","timestamp":1794360572043,"version":"4.9.0"},"reference-count":54,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,3,18]],"date-time":"2025-03-18T00:00:00Z","timestamp":1742256000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,3,18]],"date-time":"2025-03-18T00:00:00Z","timestamp":1742256000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:p>Despite rising rates of sexually transmitted infections (STIs) in Thailand, including syphilis, data on its prevalence and associated risk factors among blood donors remain scarce. This systematic review and meta-analysis aimed to estimate the prevalence of syphilis and identify the key risk factors among blood donors in Thailand to inform targeted interventions for enhanced blood safety.The study protocol was registered in PROSPERO (CRD42024560215) and conducted following PRISMA guidelines. Comprehensive searches were performed across major databases, including ProQuest, Journals@Ovid, Embase, Scopus, PubMed, and MEDLINE, to identify relevant studies. A random-effects model was used to calculate the pooled prevalence and odds ratios (ORs) for syphilis risk factors. Heterogeneity was quantified using the <jats:italic>I\u00b2<\/jats:italic> statistic, and meta-regression and subgroup analyses were employed to explore potential sources of heterogeneity. Publication bias was assessed using funnel plots and Egger\u2019s regression test. A total of 23 studies involving 1,142,910 blood donors were included. The pooled prevalence of syphilis among blood donors in Thailand was 0.42% (95% CI 0.27\u20130.66%, <jats:italic>I\u00b2<\/jats:italic>: 99.3%, number of infections: 6,173), with a decreasing trend over time. Male donors were significantly more likely to have syphilis (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.0001; pooled OR: 1.76; 95% CI 1.53\u20132.03; <jats:italic>I\u00b2<\/jats:italic>: 34.2%, 651,019 participants). First-time donors also had an elevated risk of syphilis (<jats:italic>P<\/jats:italic>\u2009=\u20090.02; pooled OR: 2.02; 95% CI 1.10\u20133.70; <jats:italic>I\u00b2<\/jats:italic>: 94.0%, 215,245 participants). Additionally, the analysis revealed a significant association between increasing age and higher syphilis risk among blood donors. The systematic review and meta-analysis indicated that syphilis prevalence among blood donors in Thailand is declining; however, male and first-time donors, as well as older age groups, remain at higher risk. To enhance blood safety, targeted interventions are needed, including refining donor screening questionnaires, expanding educational campaigns for high-risk groups, and incorporating advanced screening technologies. Strengthening and regularly updating national screening policies will ensure the effective mitigation of syphilis transmission among blood donors in Thailand.<\/jats:p>","DOI":"10.1038\/s41598-025-94332-3","type":"journal-article","created":{"date-parts":[[2025,3,18]],"date-time":"2025-03-18T13:05:33Z","timestamp":1742303133000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["A systematic review and meta-analysis of the prevalence and risk of syphilis among blood donors in Thailand"],"prefix":"10.1038","volume":"15","author":[{"given":"Rujikorn","family":"Rattanatham","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wanida","family":"Mala","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kwuntida Uthaisar","family":"Kotepui","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frederick Ramirez","family":"Masangkay","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chutima","family":"Rattanawan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Supakanya","family":"Lasom","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kinley","family":"Wangdi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manas","family":"Kotepui","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,3,18]]},"reference":[{"issue":"1","key":"94332_CR1","doi-asserted-by":"publisher","first-page":"17073","DOI":"10.1038\/nrdp.2017.73","volume":"3","author":"RW Peeling","year":"2017","unstructured":"Peeling, R. W. et al. Nat. Rev. Dis. Primers 3(1), 17073. (2017).","journal-title":"Nat. Rev. Dis. Primers"},{"issue":"2","key":"94332_CR2","doi-asserted-by":"publisher","first-page":"103","DOI":"10.1071\/SH14174","volume":"12","author":"JE Stoltey","year":"2015","unstructured":"Stoltey, J. E. & Cohen, S. E. Syphilis transmission: A review of the current evidence. Sex. Health 12(2), 103\u2013109 (2015).","journal-title":"Sex. Health"},{"issue":"2","key":"94332_CR3","doi-asserted-by":"publisher","first-page":"325","DOI":"10.1111\/trf.17707","volume":"64","author":"G Conti","year":"2024","unstructured":"Conti, G. et al. Syphilis seroprevalence and incidence in US blood donors from 2020 to 2022. Transfusion 64(2), 325\u2013333 (2024).","journal-title":"Transfusion"},{"issue":"2","key":"94332_CR4","doi-asserted-by":"publisher","first-page":"145","DOI":"10.26553\/jikm.2022.13.2.145-154","volume":"13","author":"FR Nuraini","year":"2022","unstructured":"Nuraini, F. R. & Muflikhah, N. D. Prevalence of syphilis cases among blood donors in Bojonegoro. Jurnal Ilmu Kesehatan Masyarakat 13(2), 145\u2013154 (2022).","journal-title":"Jurnal Ilmu Kesehatan Masyarakat"},{"key":"94332_CR5","doi-asserted-by":"publisher","first-page":"6431","DOI":"10.2147\/IDR.S386495","volume":"15","author":"X Chen","year":"2022","unstructured":"Chen, X. et al. Prevalence of syphilis infections among volunteer blood donors in Jinan blood center, China: A 15-year retrospective study. Infect. Drug Resist. 15, 6431\u20136440 (2022).","journal-title":"Infect. Drug Resist."},{"issue":"1","key":"94332_CR6","first-page":"1668703","volume":"2022","author":"X Zheng","year":"2022","unstructured":"Zheng, X. et al. Prevalence of Treponema pallidum antibody among volunteer blood donors in China. Can. J. Infect. Dis. Med. Microbiol. 2022(1), 1668703 (2022).","journal-title":"Can. J. Infect. Dis. Med. Microbiol."},{"issue":"11","key":"94332_CR7","doi-asserted-by":"publisher","first-page":"e024393","DOI":"10.1136\/bmjopen-2018-024393","volume":"9","author":"X Wu","year":"2019","unstructured":"Wu, X. et al. Association between syphilis seroprevalence and age among blood donors in Southern China: An observational study from 2014 to 2017. BMJ Open. 9(11), e024393 (2019).","journal-title":"BMJ Open."},{"issue":"2","key":"94332_CR8","doi-asserted-by":"publisher","first-page":"72","DOI":"10.22159\/ajpcr.2024.v17i2.49139","volume":"17","author":"A Bharti","year":"2024","unstructured":"Bharti, A., Alha, S., Mathur, R., Mahawar, N. L. & Seegar, H. Trends of syphilis among blood donors at a tertiary care center in Western Rajasthan: An observational study with special reference to the impact of COVID-19. Asian J. Pharm. Clin. Res. 17(2), 72\u201375 (2024).","journal-title":"Asian J. Pharm. Clin. Res."},{"issue":"4","key":"94332_CR9","first-page":"94","volume":"8","author":"A Brunel Monic","year":"2023","unstructured":"Brunel Monic, A. et al. Epidemiology of syphilis among blood donors in Brazzaville, Republic of congo. Appl. Microbiol. Biotechnol. 8(4), 94\u201397 (2023).","journal-title":"Appl. Microbiol. Biotechnol."},{"issue":"2","key":"94332_CR10","first-page":"8","volume":"31","author":"P Nimnuch","year":"2021","unstructured":"Nimnuch, P., Jeumjanya, N., Intharanut, K. & Nathalang, O. Prevalence of transfusion-transmitted infections in donated blood at Thammasat university hospital during 2017 to 2020. J. Hematol. Transfus. Med. 31(2), 8 (2021).","journal-title":"J. Hematol. Transfus. Med."},{"key":"94332_CR11","first-page":"105","volume":"9","author":"S Wongkham","year":"2017","unstructured":"Wongkham, S. Infection rate of HIV virus hepatitis B virus hepatitis C virus and syphilis in blood donation of Hua Hin hospital. CMJ 9, 105\u2013113 (2017).","journal-title":"CMJ"},{"issue":"1","key":"94332_CR12","first-page":"7","volume":"22","author":"W Yamket","year":"2013","unstructured":"Yamket, W. & Patchomchay, S. Prevalence of occult hepatitis B infection in blood donors at the region blood centre IV Ratchaburi. J. Health Sci. 22(1), 7 (2013).","journal-title":"J. Health Sci."},{"issue":"1","key":"94332_CR13","first-page":"72","volume":"39","author":"W Thonsiri","year":"2022","unstructured":"Thonsiri, W. Prevalence of HIV, HBV, HCV and syphilis infection in blood donors at Blood Bank Department, Prapokklao Hospital, Chanthaburi Province. T J. Prapokklao Hosp. Clin. Med. Educat Cent. 39(1), 72\u201379 (2022).","journal-title":"T J. Prapokklao Hosp. Clin. Med. Educat Cent."},{"issue":"2","key":"94332_CR14","first-page":"9","volume":"22","author":"K Sawdaeng","year":"2012","unstructured":"Sawdaeng, K., Uawijitaroon, Y., Prevalence of, H. I. V., Hepatitis, B. & Hepatitis, C. Syphilis infections in blood donors: Surveillance for improving blood donor screening. J. Hematol. Transfus. Med. 22(2), 9 (2012).","journal-title":"J. Hematol. Transfus. Med."},{"issue":"2","key":"94332_CR15","first-page":"7","volume":"18","author":"W Pattoom","year":"2008","unstructured":"Pattoom, W. et al. Prevalence of HIV, HBV and HCV infections in first-time blood donors at Somdejphrachaotaksin Maharaj Hospital, Tak Province, during 2001\u20132005. J. Transfus. Med. 18(2), 7 (2008).","journal-title":"J. Transfus. Med."},{"key":"94332_CR16","unstructured":"WHO. Global Status Report on Blood Safety and Availability 2021 (World Health Organization, 2022)."},{"key":"94332_CR17","unstructured":"National Blood Centre, Thai Red Cross Society. Testing Allogeneic Donated Blood. Standards for Blood.banks and Transfusion Service 2 edn (Udomusksa: National Blood Centre, Thai Red Cross Society, 2015)."},{"key":"94332_CR18","doi-asserted-by":"publisher","first-page":"n71","DOI":"10.1136\/bmj.n71","volume":"372","author":"MJ Page","year":"2021","unstructured":"Page, M. J. et al. The PRISMA 2020 statement: An updated guideline for reporting systematic reviews. BMJ 372, n71 (2021).","journal-title":"BMJ"},{"issue":"Pt 1","key":"94332_CR19","doi-asserted-by":"publisher","first-page":"1027","DOI":"10.1016\/j.envint.2018.07.015","volume":"121","author":"RL Morgan","year":"2018","unstructured":"Morgan, R. L., Whaley, P., Thayer, K. A. & Schunemann, H. J. Identifying the PECO: A framework for formulating good questions to explore the association of environmental and other exposures with health outcomes. Environ. Int. 121(Pt 1), 1027\u20131031 (2018).","journal-title":"Environ. Int."},{"issue":"9","key":"94332_CR20","doi-asserted-by":"publisher","first-page":"e0138237","DOI":"10.1371\/journal.pone.0138237","volume":"10","author":"NR Haddaway","year":"2015","unstructured":"Haddaway, N. R., Collins, A. M., Coughlin, D. & Kirk, S. The role of Google Scholar in evidence reviews and its applicability to grey literature searching. PLoS One. 10(9), e0138237 (2015).","journal-title":"PLoS One"},{"key":"94332_CR21","doi-asserted-by":"crossref","unstructured":"Moola, S. M. Z. et al. Chapter 7: Systematic reviews of etiology and risk: JBI; (2020). Available from: https:\/\/synthesismanual.jbi.global","DOI":"10.46658\/JBIRM-17-06"},{"issue":"2","key":"94332_CR22","doi-asserted-by":"publisher","first-page":"105","DOI":"10.1016\/j.cct.2006.04.004","volume":"28","author":"R DerSimonian","year":"2007","unstructured":"DerSimonian, R. & Kacker, R. Random-effects model for meta-analysis of clinical trials: An update. Contemp. Clin. Trials. 28(2), 105\u2013114 (2007).","journal-title":"Contemp. Clin. Trials"},{"issue":"7414","key":"94332_CR23","doi-asserted-by":"publisher","first-page":"557","DOI":"10.1136\/bmj.327.7414.557","volume":"327","author":"JP Higgins","year":"2003","unstructured":"Higgins, J. P., Thompson, S. G., Deeks, J. J. & Altman, D. G. Measuring inconsistency in meta-analyses. BMJ 327(7414), 557\u2013560 (2003).","journal-title":"BMJ"},{"key":"94332_CR24","unstructured":"Sutton, A., Abrams, K., Jones, D., Sheldon, T. & Song, F. Methods for meta-analysis in Medical Research (Wiley, 2000)."},{"issue":"7109","key":"94332_CR25","doi-asserted-by":"publisher","first-page":"629","DOI":"10.1136\/bmj.315.7109.629","volume":"315","author":"M Egger","year":"1997","unstructured":"Egger, M., Davey Smith, G., Schneider, M. & Minder, C. Bias in meta-analysis detected by a simple, graphical test. BMJ 315(7109), 629\u2013634 (1997).","journal-title":"BMJ"},{"key":"94332_CR26","unstructured":"Team, R. & RStudio Integrated Development for R. RStudio Boston, MA: PBC,; (2020). Available from: http:\/\/www.rstudio.com\/"},{"issue":"SUPPL. 1","key":"94332_CR27","first-page":"S105","volume":"80","author":"S Barusrux","year":"1997","unstructured":"Barusrux, S., Urwijitaroon, Y., Puapairoj, C., Romphruk, A. & Sriwanitchrak, P. Association of HCV and Treponema pallidum infection in HIV infected northeastern Thai male blood donors. J. Med. Assoc. Thail. 80(SUPPL. 1), S105\u2013S10 (1997).","journal-title":"J. Med. Assoc. Thail."},{"issue":"5","key":"94332_CR28","first-page":"913","volume":"39","author":"L Thaikruea","year":"2008","unstructured":"Thaikruea, L. et al. Assessment of a self-deferral form for screening blood donors, Chiang Mai University Hospital, Thailand. Southeast. Asian J. Trop. Med. Public. Health. 39(5), 913\u2013916 (2008).","journal-title":"Southeast. Asian J. Trop. Med. Public. Health"},{"issue":"3","key":"94332_CR29","first-page":"452","volume":"27","author":"Y Urwijitaroon","year":"1996","unstructured":"Urwijitaroon, Y., Barusrux, S., Romphruk, A., Puapairoj, C. & Pakote, L. Reducing the risk of HIV transmission through blood transfusion by donor self-deferral. Southeast. Asian J. Trop. Med. Public. Health 27(3), 452\u2013456 (1996).","journal-title":"Southeast. Asian J. Trop. Med. Public. Health"},{"issue":"1","key":"94332_CR30","doi-asserted-by":"publisher","first-page":"7920","DOI":"10.1038\/s41598-024-57584-z","volume":"14","author":"S Burananayok","year":"2024","unstructured":"Burananayok, S. et al. COVID-19 impact on blood donor characteristics and seroprevalence of transfusion-transmitted infections in southern Thailand between 2018 and 2022. Sci. Rep. 14(1), 7920 (2024).","journal-title":"Sci. Rep."},{"key":"94332_CR31","first-page":"8","volume":"6","author":"U Charoonruangrit","year":"1996","unstructured":"Charoonruangrit, U., Nitaya, T., Soopanit, A. & To-ngam, P. The comparative study of serological infectious disease markers among 3 groups of blood donors in Rajavithi Hospital. J. Hematol. Transfus. Med. 6, 8 (1996).","journal-title":"J. Hematol. Transfus. Med."},{"issue":"10","key":"94332_CR32","first-page":"1055","volume":"97","author":"N Chiamchanya","year":"2014","unstructured":"Chiamchanya, N. The prevalence of transfusion-transmissible infection in blood donors in Thammasat University Hospital between 2007\u20132012. J. Med. Assoc. Thail. 97(10), 1055\u20131063 (2014).","journal-title":"J. Med. Assoc. Thail."},{"issue":"2","key":"94332_CR33","first-page":"8","volume":"25","author":"S Inkanant","year":"2015","unstructured":"Inkanant, S. & Chanachaisuwan, P. Prevalence of infections in blood donors at Police General Hospital. J. Hematol. Transfus. Med. 25(2), 8 (2015).","journal-title":"J. Hematol. Transfus. Med."},{"issue":"3","key":"94332_CR34","first-page":"197","volume":"28","author":"A Jaddee","year":"2013","unstructured":"Jaddee, A. Prevalene of HIV, hepatitis B, hepatitis C and syphilis infections among blood donors. MJSBH 28(3), 197\u2013206 (2013).","journal-title":"MJSBH"},{"issue":"3","key":"94332_CR35","first-page":"8","volume":"23","author":"S Lertpaisankul","year":"2013","unstructured":"Lertpaisankul, S. & Tessomboon, S. Prevalence of syphilis, HIV, hepatitis B, and hepatitis C infections in blood donors. J. Hematol. Transfus. Med. 23(3), 8 (2013).","journal-title":"J. Hematol. Transfus. Med."},{"issue":"3","key":"94332_CR36","first-page":"41","volume":"15","author":"C Meepradit","year":"2022","unstructured":"Meepradit, C., Sintuwong, C., Inthra, S., Suwannamit, S. & Phiwpan, P. Factors associated with detection rate of infectious disease markers in blood donation of Mae Sai Hospital, 2017 to 2019. Health Sci. Sci. Technol. Reviews. 15(3), 41\u201348 (2022).","journal-title":"Health Sci. Sci. Technol. Reviews"},{"issue":"3","key":"94332_CR37","doi-asserted-by":"publisher","first-page":"264","DOI":"10.1046\/j.1537-2995.1995.35395184285.x","volume":"35","author":"Y Mundee","year":"1995","unstructured":"Mundee, Y. et al. Infectious disease markers in blood donors in northern Thailand. Transfusion 35(3), 264\u2013267 (1995).","journal-title":"Transfusion"},{"issue":"6","key":"94332_CR38","doi-asserted-by":"publisher","first-page":"730","DOI":"10.1046\/j.1537-2995.2003.00395.x","volume":"43","author":"N Nantachit","year":"2003","unstructured":"Nantachit, N. et al. Temporal trends in the prevalence of HIV and other transfusion-transmissible infections among blood donors in northern Thailand, 1990 through 2001. Transfusion 43(6), 730\u2013735 (2003).","journal-title":"Transfusion"},{"issue":"3","key":"94332_CR39","first-page":"151","volume":"23","author":"P Ratanamart","year":"2005","unstructured":"Ratanamart, P., Siammai, S. & Heembai, U. Infectious disease markers in voluntary donors and replacement donors at the Blood Bank Unit, Songklanagarind Hospital. Songklanagarind Med. J. 23(3), 151\u2013156 (2005).","journal-title":"Songklanagarind Med. J."},{"issue":"3","key":"94332_CR40","doi-asserted-by":"publisher","first-page":"242","DOI":"10.1046\/j.1537-2995.1996.36396182143.x","volume":"36","author":"P Sawanpanyalert","year":"1996","unstructured":"Sawanpanyalert, P. et al. Donation deferral criteria for human immunodeficiency virus positivity among blood donors in northern Thailand. Transfusion 36(3), 242\u2013249 (1996).","journal-title":"Transfusion"},{"issue":"1","key":"94332_CR41","first-page":"9","volume":"38","author":"D Sungsub","year":"2021","unstructured":"Sungsub, D. & Eamkaew, S. Prevalence of syphilis and treatment coverage. Buddhachinaraj Med. J. 38(1), 9\u201317 (2021).","journal-title":"Buddhachinaraj Med. J."},{"issue":"2","key":"94332_CR42","first-page":"14","volume":"45","author":"S Trakulkaseamsiri","year":"2012","unstructured":"Trakulkaseamsiri, S. & Thapyotha, C. Prevalence of hepatitis B, hepatitis C, HIV and syphilis infection in first-time blood donors at Queen Savang Vadhana Memorial Hospital, Thai Red Cross Society, during 2007\u20132011. Bull. Chiang Mai Assoc. Med. Sci. 45(2), 14 (2012).","journal-title":"Bull. Chiang Mai Assoc. Med. Sci."},{"issue":"2","key":"94332_CR43","doi-asserted-by":"publisher","first-page":"152","DOI":"10.1046\/j.1537-2995.1994.34294143945.x","volume":"34","author":"D Kitayaporn","year":"1994","unstructured":"Kitayaporn, D., Bejrachandra, S., Chongkolwatana, V., Chandanayingyong, D. & Weniger, B. G. Potential deferral criteria predictive of human immunodeficiency virus positivity among blood donors in Thailand. Transfusion 34(2), 152\u2013157 (1994).","journal-title":"Transfusion"},{"key":"94332_CR44","unstructured":"Department of Disease and Control. Syphilis situation as of January 6, 2024. Nonthaburee: Department of Disease and Control, [cited 2024 September 4]. (2024). Available from: https:\/\/ddc.moph.go.th\/disease_detail.php?d=94"},{"issue":"5","key":"94332_CR45","doi-asserted-by":"publisher","first-page":"355","DOI":"10.1111\/tme.12988","volume":"33","author":"S Puerto-Meredith","year":"2023","unstructured":"Puerto-Meredith, S. et al. Systematic review of prevalence and risk factors of transfusion transmissible infections among blood donors, and blood safety improvements in Southern Africa. Transfus. Med. 33(5), 355\u2013371 (2023).","journal-title":"Transfus. Med."},{"issue":"0","key":"94332_CR46","first-page":"10247","volume":"0","author":"M El-Jamal","year":"2024","unstructured":"El-Jamal, M. et al. Syphilis infection prevalence in the middle East and North Africa: A systematic review and meta-analysis. eClinicalMedicine 0(0), 10247 (2024).","journal-title":"eClinicalMedicine"},{"issue":"4","key":"94332_CR47","doi-asserted-by":"publisher","first-page":"304","DOI":"10.2471\/BLT.20.254003","volume":"99","author":"M Sharma","year":"2021","unstructured":"Sharma, M. et al. Control of sexually transmitted infections and global elimination targets, South-East Asia region. Bull. World Health Organ. 99(4), 304\u2013311 (2021).","journal-title":"Bull. World Health Organ."},{"issue":"5","key":"94332_CR48","doi-asserted-by":"publisher","first-page":"e0004711","DOI":"10.1371\/journal.pntd.0004711","volume":"10","author":"CR Kenyon","year":"2016","unstructured":"Kenyon, C. R., Osbak, K. & Tsoumanis, A. The global epidemiology of syphilis in the past century - a systematic review based on antenatal syphilis prevalence. PLoS Negl. Trop. Dis. 10(5), e0004711 (2016).","journal-title":"PLoS Negl. Trop. Dis."},{"issue":"1","key":"94332_CR49","doi-asserted-by":"publisher","first-page":"119","DOI":"10.1186\/s12916-019-1349-y","volume":"17","author":"H Chemaitelly","year":"2019","unstructured":"Chemaitelly, H., Weiss, H. A., Calvert, C., Harfouche, M. & Abu-Raddad, L. J. HIV epidemiology among female sex workers and their clients in the middle East and North Africa: Systematic review, meta-analyses, and meta-regressions. BMC Med. 17(1), 119 (2019).","journal-title":"BMC Med."},{"issue":"2","key":"94332_CR50","doi-asserted-by":"publisher","first-page":"110","DOI":"10.1016\/j.clindermatol.2023.12.002","volume":"42","author":"K Sinka","year":"2024","unstructured":"Sinka, K. The global burden of sexually transmitted infections. Clin. Dermatol. 42(2), 110\u2013118 (2024).","journal-title":"Clin. Dermatol."},{"issue":"7","key":"94332_CR51","doi-asserted-by":"publisher","first-page":"1256","DOI":"10.3390\/microorganisms12071256","volume":"12","author":"S Nanoudis","year":"2024","unstructured":"Nanoudis, S. et al. Prevalence and treatment outcomes of syphilis among people with human immunodeficiency virus (HIV) engaging in high-risk sexual behavior: Real world data from Northern Greece, 2019\u20132022. Microorganisms 12(7), 1256 (2024).","journal-title":"Microorganisms"},{"issue":"8","key":"94332_CR52","doi-asserted-by":"publisher","first-page":"e1110","DOI":"10.1016\/S2214-109X(21)00221-7","volume":"9","author":"M Tsuboi","year":"2021","unstructured":"Tsuboi, M. et al. Prevalence of syphilis among men who have sex with men: A global systematic review and meta-analysis from 2000-20. Lancet Glob Health. 9(8), e1110\u2013e8 (2021).","journal-title":"Lancet Glob Health"},{"key":"94332_CR53","doi-asserted-by":"crossref","unstructured":"Matteelli, A., Carvalho, A. C. C. & Schlagenhauf, P. Sexually transmitted infections. Essent. Travel Med. 103\u2009\u2013\u200914  (2015).","DOI":"10.1002\/9781118597361.ch11"},{"key":"94332_CR54","first-page":"310","volume":"47","author":"X Gong","year":"2014","unstructured":"Gong, X., Yue, X., Teng, F., Jiang, N. & Men, P. Syphilis in China from 2000 to 2013: Epidemiological trends and characteristics. Chin. J. Dermatol. 47, 310\u2013315 (2014).","journal-title":"Chin. J. Dermatol."}],"container-title":["Scientific Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41598-025-94332-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-025-94332-3","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-025-94332-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,3,18]],"date-time":"2025-03-18T13:07:46Z","timestamp":1742303266000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41598-025-94332-3"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3,18]]},"references-count":54,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["94332"],"URL":"https:\/\/doi.org\/10.1038\/s41598-025-94332-3","relation":{},"ISSN":["2045-2322"],"issn-type":[{"value":"2045-2322","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,3,18]]},"assertion":[{"value":"9 September 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"13 March 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"18 March 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"9316"}}